Billions spent to keep people sick as hospitals buckle under pressure

Doctors call for an overhaul of Australia’s ‘sickcare’ system, saying governments should be ‘spending to save’ and keep people healthy.

AMA president professor Steve Robson. Supplied

Australia pours billions of dollars every year into funding a “sick­care” system rather than keeping well, leading to unsustainable pressure on hospitals, mass inefficiencies, and a critical lack of investment in preventive care.

That’s the assessment of the Australian Medical Association, which is calling for a fundamental overhaul in the way the nation’s leaders think about healthcare ­investment.

AMA president Steve Robson will tell the National Press Club on Wednesday that the health system urgently requires greater investment, and that if the money is spent in ways that keep people healthy, it will reap billions in savings across the economy from greater workforce participation as well as ultimately resulting in patients needing less expensive care.

“Health should not be seen just as a ‘spending portfolio’,” he will say. “It should be seen as a productivity portfolio. We should be spending to save. The evidence abounds for the benefits.”

Professor Robson warns that underinvestment in health, such as has occurred in Britain with the National Health Service, can lead to system collapse, and the state of Australian hospitals as well the general practice sector should spark significant concern.

“Australians are now experiencing the consequences of decades of neglect of general practice by successive governments,” Professor Robson will say. “While our primary care system struggles, the issues in our public hospitals are laid bare by story after story of people unable to get from an ambulance to a bed, unable to get surgery, unable even to get to see a specialist to get on a waiting list.”

Pressures on our public hospitals mean Australians are dying in ramped ambulances or waiting for ambulances to arrive. Yet despite incredible increases in demand, over the past decade the connection between funding, and performance and improvement outcomes has been removed.

In a report to be released at the same time as Professor Robson’s speech on Wednesday, the AMA has revealed that by its calculations, the cost to the economy of lost wages from patients stuck on public surgery waiting lists is as much as $4.6bn a year.

But if funds were invested in the health system in a strategic way that prioritised preventive health, large savings would ultimately be reaped.

According to the report – entitled Health is the Best Investment: Shifting from a sickcare system to a healthcare system – investing in the delivery of evidence-based wound care would save an estimated $203.4m over four years; addressing hospital exit block would save as much as $2bn a year; and a tax on sugar-sweetened beverages would reduce chronic disease costs by about $1bn a year.

Professor Robson is also reiterating the AMA’s call to overhaul the National Health Reform Agreement, which governs policy and spending on public hospitals.

“The agreement needs a total refresh to deal with the pandemic legacy that’s left our hospitals in such a mess,” Professor Robson will say. “The current agreement does little to improve performance, ignores quality, and has no focus on preventing avoidable ­admissions – perhaps the biggest problem of all.”